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Vascular I & Physics I > Ch. 11 Vascular > Flashcards

Ch. 11 Vascular Flashcards

(88 cards)

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1
Q

In POAD, intermittent claudication is

A

pain in large muscle groups caused by activity that subsides with rest

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2
Q

Where does intermittent claudication usually occur where in the body? and approx. what location of each portion?

A

calf, thighs, buttocks, distal to the site of disease

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3
Q

What are risk factors of PAOD

A

smoking, diabetes, obesity, high blood pressure, high cholesterol, high triglycerides

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4
Q

TRUE claudication symptoms are

A

relieved with quiet standing, easily reproducible with the same amount of activity

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5
Q

What are some diseases that mimic claudication

A

SPINAL STENOSIS, herniated disk, osteoarthritis

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6
Q

What disease would be relieved by sitting down

A

spinal stenosis

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7
Q

In PAOD, what are the symptoms of rest pain

A

pain in foot while patient is lying down, represents increasing severity of disease

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8
Q

What are advanced symptoms of PAOD

A

thickening of toenails and loss of toe hair, skin discoloration and scaliness, elevation pallor, dependent rubor, ulceration/gangrene, blue toes may indicate aneurysmal disease

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9
Q

Blanching of leg if raised above heart level

A

elevation pallor

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10
Q

Feet turn red over the toes and foot when hanging down

A

dependent rubor

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11
Q

What should patient position be for PAOD

A

supine with head on pillow and NOT elevated, SAME LEVEL AS THE HEART

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12
Q

For systolic pressures, it is important to let the patient rest for _____ before beginning exam

A

10-15 mins

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13
Q

Why do patients need to rest before the exam

A

to ensure true resting levels of blood flow

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14
Q

What should the width of the cuff be for systolic pressure

A

20% wider than the diameter of underlying limb

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15
Q

What happens if the cuff is too narrow

A

falsely elevated pressure

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16
Q

What happens if the cuff is too wide

A

falsely lower pressure

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17
Q

For ABIS, cuffs are placed

A

upper arm and ankle

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18
Q

For multilevel lower extremity pressures, cuffs are placed

A

upper arm, thigh, calf, ankles

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19
Q

Doppler signal is obtained _____ to cuff

A

distal

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20
Q

Where are the cuffs placed distally

A

PTA or DPA

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21
Q

Once doppler signal is obtained, cuff is inflated to

A

register systolic pressure

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22
Q

The cuff should be inflated to

A

20mmHg above point where signal disappears

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23
Q

Cuff should be deflated at a rate of

A

about 3 mmHg/s

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24
Q

How do you calculate ABI

A

by dividing highest systolic ankle pressure by the higher of the two brachial systolic pressures

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25
What systolic pressures should all be calculated for ABI
bilateral brachial, PTA, DPA
26
What is normal ABI
1.0`
27
A change of _____ between repeat studies is considered significant
0.15
28
What ABI values correspond with worsening PAOD
lower
29
What ABI values typically correspond to calcified arteries
excessively high
30
Systolic pressure is invalid when the underlying artery is calcified and incompressible. T/F
T
31
ABI identifies overall severity of PAOD but not necessarily
the site
32
What can add additional information to ABI about disease location
segmental limb systolic pressures
33
How is the 3 cuff method performed
one large cuff on thigh, one cuff around calf just below the knee and one cuff at the ankle
34
How is the 4 cuff method performed
two smaller cuffs on thigh (high thigh and above knee), one at calf and one at ankle
35
What does the 4 cuff method have the ability to define level of disease and separate
iliofemoral disease from superficial femoral artery disease
36
In SLSP, doppler signal is obtained where and pressures are abstained from where
ankle / ankle, calf and thigh levels (START DISTALLY AND MOVE SUPERIORLY)
37
What pressure is used in SLSP for pressure measurement up the limb
highest of the PTA or DPA
38
MAIN DETERMINANT of doppler characteristics is
peripheral resistance
39
Systolic pressures usually ______ as blood flows distally in the lower extremity
increase
40
_________ affects the amplitude of the waveform as you travel ______
increased peripheral resistance, distally
41
Any reduction in DISTAL pressure should be ______ between adjacent segments
<30mmHg
42
Pressure drop >30mmHg indicates presence of
proximal obstruction
43
The width of thigh cuff changes interpretation. A single ____ thigh cuff results in a thigh pressure _____ to the _____ pressure
large, equal, brachial
44
Use of a narrower thigh cuff results in ______ thigh pressure
higher
45
What is exercise testing primarily used for
patients with intermittent claudication with normal or close to normal ABIs at rest
46
Typical treadmill settings are
10% grade, 1-2 mph, walking time of 5 mins
47
What are the contraindications for treadmill testing
chest pain, arrhythmias, post MI or cardiac procedure, unsteadiness, hypertension
48
What is considered hypertension
>180mmHg
49
Lowest value of post activity ABI categorizes
functional severity of the limb
50
ABI that returns to pre-exercise level within 5 mins is associated with
single level disease
51
ABI that returns to pre-exercise level >10 mins is associated with
multilevel disease
52
What angle to the skin should be used for doppler waveforms
45 degrees
53
What are normal doppler waveforms
bi- to triphasic
54
Flow reversal related to greater
resistance flow
55
What is (air) plethysmophraphy also called
pulse volume recording (PVR), volume pulse recording (VPR)
56
Does plethysmography identify specific arteries
no
57
Like segmental pressures, plethysmography can use either
one or two cuffs on the thigh plus one calf cuff and one ankle cuff
58
In plethysmography, each cuff is inflated to
55-65 mmHg
59
What happens to VENOUS flow during plethysmography when cuffs are inflated
it is restricted
60
Changes under the cuff are from
arterial inflow
61
NORMAL PVR waveforms should include
rapid upstroke with well-defined peak, dicrotic notch, bends towards baseline through diastole
62
Result of the reflected wave in healthy high resistance vessels
dicrotic notch
63
In plethysmography, moderate to severe disease has waveforms of
delayed onset peak, round peak, convex diastolic phase
64
What does TBI stand for
toe-brachial index
65
What is a normal TBI value
greater than or equal to 0.8
66
When is TBI useful
when ankle vessels are incompressible
67
Tow pressure of ______ indicates adequate pressure for healing
50mmHg
68
PAOD in the upper extremity is encountered in ____ of all cases
<5%
69
Upper extremity PAOD typically occurs as
TOS syndrome, Raynaud disease
70
What are symptoms of thoracic outlet syndrome
numbness, aching, tiredness with positional changes of the shoulder
71
Where is PAOD most likely to happen in the upper extremity
subclavian, proximal axillary arteries
72
____ difference in brachial systolic pressures indicates presence of subclavian artery stenosis
>20mmHg
73
What does DBI stand for
digital-brachial index
74
What is a normal DBI value
greater than or equal to 0.9
75
scular compression by structures in the shoulder girdle is called
thoracic outlet syndrome
76
In TOS, compression is a common finding but what is rare to experience
symptoms, especially with arterial compression
77
_____ may have neurovascular compression of the structures of the ____ and be ______
60%, shoulder, asymptomatic
78
Symptoms of TOS can be
reproduced in a specific position or with a particular activity
79
How is TOS commonly tested
using PPG to record digital waveforms
80
What are the positions for TOS
arms resting in lap, military position, arms elevated above head, arms abducted rearward, adson maneuver
81
What is the military position
elbows to rear and arms upright, palms front
82
what is the adson maneuver
arms straight out to sides with head ahead, then left, then right
83
Raynaud disease can be classified as either
primary or secondary
84
What is primary raynaud
vasospasm only
85
What is secondary raynaud
fixed obstruction with associated vasospasm
86
Primary raynaud tends to affect what age and gender of patients
teens, female
87
What colors do the hands change to during raynauds
white, then blue, then red (with warming)
88
What test is used to determine digital perfusion prior to certain surgical procedures
allen test

Vascular I & Physics I (19 decks)

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